摘要
目的:探讨不同病原菌对脓毒症相关性急性肾损伤患者预后的影响。方法:回顾本院综合ICU自2016年1月-2018年4月收治的61例符合脓毒症相关性急性肾损伤患者的临床资料,分别记录患者脓毒症的原发感染部位及病原菌种类和患者入住ICU天数、死亡率差异及肾功能恢复率,分析感染部位和病原菌种类对患者预后的影响。结果:呼吸道感染(60.66%)是脓毒症相关性急性肾损伤的常见感染,其次是泌尿系感染(18.03%)和腹腔感染(14.75%)。在呼吸道感染致病菌排序:肺炎克雷伯菌>铜绿假单胞菌、大肠埃希菌、真菌;在泌尿系感染中,大肠埃希菌>真菌>肺炎克雷伯菌;在腹腔感染中,大肠埃希菌>肺炎克雷伯菌>鲍曼不动杆菌。原发感染部位为呼吸道感染的死亡率最高为49.95%;肺炎克雷伯菌感染死亡率最高为45.00%;超过30 d肾功能未恢复至正常者以大肠埃希菌感染(7.32%)居多。结论:呼吸道和泌尿系是脓毒症相关性急性肾损伤的常见感染部位,肺炎克雷伯菌和大肠埃希菌不仅是导致脓毒症相关性急性肾损伤常见致病菌,并且由此感染的患者病死率高,肾功能损伤重且恢复慢。
Objective:To explore the effect of different pathogenic bacteria on the prognosis of septic related acute kidney injury patients.Method:The clinical data of 61 patients with acute kidney injury related sepsis were reviewed from January 2016 to April 2018 in our integrative ICU.The site of primary infection and the types of pathogenic bacteria in patients with sepsis and the number of patients admitted to the ICU days,the difference in mortality and the rate of renal function recovery were recorded respectively,the effect of infection site and pathogen on prognosis was analyzed.Result:Respiratory tract infection (60.66%) was the common site of sepsis related acute kidney injury,followed by urinary tract infection (18.03%) and peritoneal infection(14.75%).The order of pathogenic bacteria in respiratory tract infection:Klebsiella pneumoniae >Pseudomonas aeruginosa,Escherichia coli and fungi;in urinary tract infection,Escherichia coli >fungi >Klebsiella pneumoniae;in abdominal infection,Escherichia coli >Klebsiella pneumoniae >Acinetobacter Bauman.The mortality rate of respiratory tract infection was the highest (49.95%),and Klebsiella pneumoniae infection was the highest(45.00%),the escherichia coli infection (7.32%) was the majority of those whose renal function did not return to normal for more than 30 days.Conclusion:Respiratory tract and urinary system are the common infection sites of sepsis-associated acute kidney injury,Klebsiella pneumoniae and Escherichia coli are not only the common pathogenic bacteria that lead to sepsis-related acute kidney injury,but also the patients infected by this infection have a high mortality,severe renal function injury and slow recovery.
作者
王春青
王道理
黄海望
WANG Chunqing;WANG Daoli;HUANG Haiwang(Haicang Hospital of Xiamen,Xiamen 361026,China)
出处
《中国医学创新》
CAS
2019年第3期149-153,共5页
Medical Innovation of China
关键词
病原菌
脓毒症
急性肾损伤
Pathogenic bacteria
Sepsis
Acute kidney injury
